Unitary pharmaceutical dosage form

ABSTRACT

In accordance with this invention a novel pharmaceutical product containing efavirenz, emtricitabine and tenofovir DF are provided as a multicomponent unitary oral dosage form, component 1 comprising tenofovir DF (and, optionally, emtricitabine) and component 2 comprising efavirenz, wherein components 1 and 2 are in a stabilizing configuration. In preferred embodiments component 1 is made by dry granulation.

BACKGROUND OF THE INVENTION

This application relates to products for the treatment of viralinfections, in particular HIV infections, using the known antiviralcompounds efavirenz (tradename Sustiva, also known as EFV),emtricitabine (tradename Emtriva, also known as FTC) and tenofovir DF(disoproxil fumarate, also known as TDF) (tradename Viread, sold incombination with emtricitabine under the tradename Truvada).

The Truvada product is produced by wet granulation of emtricitabine andtenofovir DF (WO 04/64845), which under the circumstances produces achemically stable dosage form. This product does not contain efavirenz.

HIV therapy using efavirenz as well as emtricitabine and tenofovir DFhas been considered desirable (hereafter “triple combination”; see WO04/64845). Manufacturing a commercially viable triple combinationproduct, however, would require that the final product meet stringentFDA requirements for bioequivalence to the commercial products, Viread(tenofovir disoproxil fumarate), Emtriva (emtricitabine), and Sustiva(efavirenz), and that the tablet be of suitable size for patients toeasily swallow.

Initial efforts to simply combine the three drugs (active pharmaceuticalintermediates, or APIs) into a unitary, essentially homogeneouscomposition manufactured by wet granulation failed to produce achemically stable tablet. The tenofovir DF in this combination tabletwas highly unstable and rapidly degraded in stability studies. Theefavirenz formulation was unexpectedly incompatible with tenofovir DF, aresult now attributed to the surfactant (sodium lauryl sulfate) found inthe efavirenz portion of the formulation.

Another attempt was made to produce the triple combination, this timeusing a dry granulation of the three part combination and omitting thesurfactant. This resulted in a tablet that failed to achievebioequivalence with respect to efavirenz in human clinical trials. Thepeak efavirenz concentration in the blood stream and total drug exposure(Cmax and AUC) were both below the parameters determined for thecommercial comparator, Sustiva (efavirenz) tablets. The inventorsconcluded that at least the surfactant in the triple combination(efavirenz/emtricitabine/tenofovir disoproxil fumarate) tablets wasnecessary to achieve bioequivalence to Sustiva.

Next, combination tablets were manufactured by wet granulating theefavirenz component with the surfactant and other excipients, separatelymanufacturing the Truvada component using dry granulation, mixing thegranulates together, compressing the mixture into tablets, and thenfilm-coating the tablets. Unexpectedly, this approach also failed toproduce the desired bioequivalence in between the commercial product,Sustiva (efavirenz), and clinical trial material (i.e., proposedcommercial triple combination product). A novel and inventive step wasneeded to overcome the shortcomings of more straight-forward approachesto a triple combination dosage form.

Copending U.S. Ser. No. 60/771,353 (filed of even date and expresslyincorporated herein by reference) is directed to solving anotherobstacle encountered in the preparation of the triple combination dosageform, that of reducing the size of the combined product. While the priorart reports the successful manufacture of chemically stable Truvadapreparations (WO04/64845), these preparations contain relatively lowproportions of excipient to API. Increasing the proportion of excipientsand wet granulating the three API combination unexpectedly resulted in apreparation in which the tenofovir DF was highly unstable. As reportedin U.S. Ser. No. 60/771,353, it was believed that use of sufficientwater to accomplish the wet granulation of efavirenz (which hasrelatively low solubility in comparison to emtricitabine and tenofovirDF) caused the latter two APIs to dissolve into a eutectic mixture. Theeutectic mixture dried during granulation to form a glassy or amorphousproduct in which the tenofovir DF is chemically unstable in comparisonto the crystalline API. Supplying enough excipient to ameliorate theeffect of the excess water was not consistent with the objective ofobtaining a triple combination oral dosage form of manageableproportions.

As described further in U.S. Ser. No. 60/771,353, this obstacle wasovercome by dry granulating the emtricitabine and tenofovir DFcomposition, i.e., granulating the composition without contacting samewith a destabilizing amount of liquid water. Omitting water(particularly, liquid water) or reducing the presence of water to aninsubstantial amount eliminates the disadvantageous formation of aeutectic mixture and enhances the stability of the resultingpharmaceutical product.

Despite the advantages conferred by dry granulation of theemtricitabine/tenofovir DF component, it was still necessary to overcomethe unexpected incompatibility of tenofovir DF and the surfactant usedin the Sustiva formulation.

SUMMARY OF THE INVENTION

In accordance with this invention, the stability and bioequivalenceobjectives for the triple combination product have been achieved byproviding a multicomponent dosage form, one component comprisingtenofovir DF and, optionally, emtricitabine, and the other comprising atleast efavirenz. Another embodiment of the invention is a dosage formcomprising a tenofovir DF component and a surfactant component not indestabilizing contact with the tenofovir DF component.

DETAILED DESCRIPTION OF THE INVENTION

The dosage form of this invention comprises efavirenz, emtricitabine andtenfovir DF. As noted, tenofovir DF and efavirenz are in separatecomponents. Emtricitabine generally is included in the tenofovir DFcomponent, but in other embodiments the emtricitabine is present in itsown component, or is mixed with the efavirenz component. Its dispositionis not critical to the practice of this invention. All that is necessaryis that emtricitabine be present in the dosage form and that thetenofovir DF component be substantially separated from the surfactant inthe efavirenz component. Any method, additive, process feature orconfiguration that suitably minimizes the contact of surfactant withtenofovir DF is suitable in the practice of this invention.

The term “component” means a physically discrete unit or compartmentwhich is associated physically with and in contact with othercomponents. This does not mean that the units or compartments arephysically not in contact. In fact, it generally is preferred that theyare in physical contact and form a unitary device, article orcomposition. The degree of association is only that which is needed tofacilitate the oral consumption of the composition as a single dosageform. This invention does not include, for example, patient packs withthe Sustiva and Truvada products in separate wells or containers, orother associations which are essentially packaging solutions alone(although, of course, the compositions of this invention optionally arepacked or packaged in any conventional fashion suitable under thecircumstances).

Typically, the components of the dosage form of this inventionconveniently are organized in multiple layers, ordinarily a bilayer asshown in the exemplified embodiment. However, if emtricitabine ispresent in its own component then the dosage form will constitute atleast a trilayer structure. There need not be a single component foreach drug (for example, the dosage forms optionally include 2 layers foreach of the components, for a total of 6). Thus, the dosage unitincludes laminates of many components. There do not need to be equalnumbers of each component, e.g., layers, for each drug or drugcombination so long as the total dosage of all components in sum is thedesired amount.

Other means for spatially organizing the components are suitable so longas the desired degree of separation of tenofovir DF and surfactant isaccomplished. For example, rather than forming planar layers along theaxis of a tablet, the components optionally are organized in an annularfashion, with each ring or cylinder containing a separate component.Another alternative is to employ a press coating process to associatethe components.

The components generally are in direct contact with one another, i.e.,no barrier or protective layer is present between them. In otherembodiments, a barrier is introduced between the incompatiblecomponents. A suitable example of this embodiment of the invention wouldbe a multi-compartment capsule in which the incompatible components aredistributed into separate compartments. Alternatively, a tablet isoptionally provided that contains one encapsulated component disbursedor distributed within the incompatible component. In general, intimate,direct admixture of the incompatible components is undesirable unlessmeans are provided to protect the tenofovir DF component fromsurfactant.

In typical embodiments the components of the dosage form of thisinvention are spatially organized so as to not place the tenofovir DFcomponent into destabilizing contact with the surfactant in theefavirenz component. “Destabilizing” means any contact between tenofovirDF and the surfactant that is capable causing pharmaceuticallyunacceptable degradation of tenofovir DF. A stabilizing configuration isany spatial organization of the tenofovir DF and efavirenz componentsthat does not result in the generation of a “pharmaceuticallyunacceptable amount” of any one of the following degradation products. Adestabilizing contact is a spatial organization that results in thegeneration of any of the following degradation products in a“pharmaceutically unacceptable amount”.

The spatial geometry and conditions of the permitted contact betweentenofovir DF and surfactant-containing component are essentiallyunlimited. This spatial geometry is termed a “stabilizing configuration”or, stated differently, is a configuration that does not contain a“destabilizing contact” as defined below. There are many ways in whichthe central observation of this invention (that is, that sodium laurylsulfate destabilizes tenofovir DF) can be harnessed to prevent thegeneration of pharmaceutically unacceptable levels of degradation oftenofovir DF.

In addition, when emtricitabine is present in the tenofovir DFcomponent, the permitted contact also that which does not producepharmaceutically unacceptable amounts of emtricitabine degradationproduct.

“Degradation” of tenofovir DF is the generation—in pharmaceuticallyunacceptable amounts—of at least one of the degradation productsmono-POC PMPA, dimer or mixed dimer. “Degradation” of FTC is defined asthe generation—in pharmaceutically unacceptable amounts, of FTU. Thesedegradation products are shown below.

Mono-POC PMPA

Dimeric Degradation Products

A “pharmaceutically unacceptable amount” is defined as the followingamounts of each degradation product. Degradation products optionally areassayed in either an absolute or incremental amount. The absolute ortotal amount of degradation product is simply the amount found in thetest article. The incremental amount is the additional amount ofdegradation product appearing in the product over that which was present(if any) in the API starting material. Moreover, the amount ofdegradation product optionally is measured at two points in time. One isat the time of release into the marketplace. The other is after exposureto storage conditions under the conditions described below, i.e., theshelf life as set forth below.

Total Amounts at Release (First Commercial Sale)

No more than about 3%, ordinarily about 1.5%, of mono-POC PMPA,

No more than about 1%, ordinarily about 0.5% of Dimer,

No more than about 0.5%, ordinarily about 0.25% of Mixed Dimer.

Less than about 0.5%, ordinarily about 0.2% of FTU

Total Amounts at Shelf Life (Storage at 25° C./60% RH for 24 mo.)

No more than about 10%, ordinarily about 5% of mono-POC PMPA,

No more than about 2%, ordinarily about 1% of Dimer,

No more than about 2%, ordinarily about 1% of Mixed Dimer.

No more than about 4%, ordinarily about 2% of FTU

Incremental Amounts at Release (First Commercial Sale)

No more than about 2%, ordinarily about 0.5%, of mono-POC PMPA,

No more than about 0.6%, ordinarily about 0.1% of Dimer,

No more than about 0.3%, ordinarily about 0.05% of Mixed Dimer.

Less than about 0.4%, ordinarily about 0.1% of FTU

Incremental Amounts at Shelf Life (Storage at 25° C./60% RH for 24 Mo.)

No more than about 9%, ordinarily about 4% of mono-POC PMPA,

No more than about 1.6%, ordinarily about 0.6% of Dimer,

No more than about 1.8%, ordinarily about 0.8% of Mixed Dimer.

No more than about 3.9%, ordinarily about 1.9% of FTU.

The percentage of degradation products is the amount of degradationproduct as measured by HPLC retention time comparison. In the HPLCretention time comparison, the retention time of the main peaks observedin the tablets is required to be within 2% of the retention time of themain peaks in the a reference standard preparation containing efavirenz,emtricitabine, and tenofovir DF in an assay which has been shown to bespecific for efavirenz, emtricitabine, and tenofovir DF. The percentageis determined by dividing the total amount of tenofovir DF plus thethree degradation products into the amount of individual degradationproduct as determined by the HPLC assay.

These parameters are employed to evaluate whether a test composition hasmet the requirements of a stabilizing contact. For example, a triplecombination dosage form optionally is designed as a shaped articlecomprising slugs of compressed granules of the tenofovir DF componentdispersed within a matrix of the efavirenz component. A variety of slugsizes might be used in making the composition. This constellation ofpotential products then would be tested, or stored under, the conditionsabove and then tested, to assay the generation of tenofovir DF and/orFTC degradation products. If the resulting product upon release did notcontain more than the specified approximate limits of any one or more ofthe 4 contaminants listed under any of the 4 assay paradigms above, thenthe contact would be considered stabilizing. Of course, the artisan mayadopt more stringent standards, but this will be a matter of choice andshall not limit the scope of this invention.

In preferred embodiments the emtricitabine and tenofovir DF are combinedand this component is prepared by dry granulation (U.S. Ser. No.60/771,353). In preferred embodiments, a composition comprising drygranulated tenofovir DF and emtricitabine is employed in one componentof the dosage forms of this invention.

Dry granulation is a well-known pharmaceutical manufacturing process perse. In general, API is combined with excipients and lubricant excipientand then compressed to form a mass. This mass typically is thencomminuted or milled, then sieved to obtain the desired size ofparticle. The granular product is compressed into tablets, filled intocapsules or otherwise formed into a unitary dosage form in conventionalfashion.

Compression into a mass is accomplished by conventional equipment.Typically, the API and excipients are passed through a roller apparatusfor compaction. However, other means for compacting the API mixture,e.g., compaction into slugs (or “slugging”), optionally are used.

A dry granulation process is one in which a dry composition of the APIand selected excipient(s) is compressed to form a mass, which iscomminuted or milled if necessary, and then optionally sieved to producethe desired size granules. Compression into a mass is accomplished byconventional equipment. Typically, the API and excipients are passedthrough a roller apparatus for compaction. However, other means forcompacting the API mixture, e.g., compaction into slugs (or “slugging”),can be used.

A composition comprising dry granulated emtricitabine and tenofovir DFis the product of a dry granulation process. This compositionessentially retains the crystalline APIs and is substantially free ofdried eutectic emtricitabine/tenofovir DF. It typically will containless than about 15% by weight dried eutectic mixture, ordinarily lessthan about 10% and generally less than about 5%.

The dry granulation process is conducted in the absence of adestabilizing amount of water, “destabilizing” being that amount ofliquid water that is capable causing pharmaceutically unacceptabledegradation of tenofovir DF and/or FTC as defined herein. If the dosageform of this invention includes a dry granulated emtricitabine/tenofovirOF component, then the amount of permitted degradation product in thefinal dosage form is still the same as that which is set forth above,i.e., the amount of water exposure and contact, together or alone, arenot to result in degradation products failing to meet the standardsdescribed above. It is an option, of course, to test the dry granulatesfor their level of degradation product first, and if they pass, then toformulate them into the dosage form of this invention and then determineif the contact results in any increase in degradation products thattakes the resulting dosage form outside the parameters established.

Bound, entrained or absorbed water are commonly present in excipients.This water will not significantly adversely affect the stability oftenofovir DF and thus is not excluded from the dry granulates optionallyused in the dosage form of this invention. In general, liquid water(added or generated in situ) from any source, e.g., chemical reactions,condensation, entrained ice, or the like is to be excluded from thegranulation. However, minor amounts of liquid water optionally are addedduring granulation. These amounts typically would be less than about 5%by weight, ordinarily less than about 1% by weight, however the water isgenerated or supplied. Water is present in the final granulation productup to about 10% by weight (Karl Fischer), but preferably is less, as lowas 0.1% by weight. However, permitted quantities of water may varydepending upon other factors in the granulation, e.g., excipient type,temperature and so forth. For example, if a hygroscopic excipient isincluded this will convert added water into a bound form. All that isnecessary is that the water not result in degradation of tenofovir DFand/or emtricitabine in the final product. In general, water is excludedboth from the pregranulation stage (preparation of the composition to beused directly in the granulation) as well as during the granulationprocess itself.

Absence of water or “dry” does not mean the absence of liquid.Granulations with organic solvents are also feasible provided thatdestabilizing amounts of water are excluded.

Dry granulation results in a product that contains minimal amounts ofwater. The amount of water in the product granulate or dosage forms madetherefrom are measured by loss on drying (LOD) or by the Karl Fischermethod. The LOD of compositions of this invention are about 15%, about10%, about 5% or typically less than about 3% by weight. The KarlFischer water is about from 0.1 to 10% by weight, usually less thanabout 5% by weight, or less than about 2%. The amount of water in thefinal preparations, as opposed to the granulates, is a function ofgranulate water as well as minor amounts of water used during subsequentprocess steps such as coating. These amounts of water added in latersteps than granulation generally will not affect the stability of theemtricitabine/tenofovir DF APIs, and therefore are subject toconsiderable permitted variation.

The manufacturing process described below is directed to the preparationof a triple combination tablet containing efavirenz, emtricitabine andtenofovir DF. In this particular embodiment the last two drugs areemplaced in a portion of the tablet which is separate from, but incontact with, the portion of the tablet containing efavirenz. It will beunderstood, however, that the emtricitabine and tenofovir DF componentof the tablet, which is an embodiment of this invention, optionally ismanufactured as a stand-alone product and not necessarily in assemblywith an efavirenz component. In this option, the emtricitabine/tenofovirDF dry granulation intermediate described below is simply compressedinto tablets or conventionally processed into other conventional unitarydosage forms such as capsules, cachets, suppositories, or the like.

The dosage forms of this invention are stored in containers, preferablyunder desiccant such as silica gel in amounts generally sufficient tomaintain the RH over the dosage forms at under about 10%, preferablyunder about 5%.

Materials

The quantitative compositions of the efavirenz powder blend, FTC/TDFpowder blend, and film-coated bi-layer EFV/FTC/TDF tablets are listed inTable 1, Table 2, and Table 3, respectively. The quantities ofefavirenz, emtricitabine, and tenofovir DF were adjusted for drugcontent factors (DCF) if the value was less than 0.99 with a concomitantreduction to the quantity of microcrystalline cellulose in eachgranulation.

TABLE 1 Quantitative composition of efavirenz powder blend % w/w UnitFormula Ingredient of Total (mg/tablet) Efavirenz 38.71 600.0Microcrystalline Cellulose, NF/EP 11.52 178.6 Hydroxypropyl cellulose,NF/EP 2.48 38.4 Sodium Lauryl Sulfate, USP/EP 0.77 12.0 CroscarmelloseSodium, NF/EP 3.87 48.0 Magnesium Stearate, NF/EP 0.58 9.6 Total forTablet Core 57.94 898.0

TABLE 2 Quantitative composition of FTC/TDF powder blend % w/w UnitFormula Ingredient of Total (mg/tablet) Emtricitabine 12.90 200.0Tenofovir Disoproxil Fumarate 19.35 300.0 Microcrystalline Cellulose,NF/EP 5.77 89.5 Croscarmellose Sodium, NF/EP^(a) 3.10 48.0 MagnesiumStearate, NF/EP^(a) 0.94 14.5 Total for Tablet Core 42.06 652.0 ^(a)Tobe incorporated into both the intragranular and extragranular portionsof the formulation during the manufacturing process.

TABLE 3 Quantitative composition of film-coated bi-layer EFV/FTC/TDFTablets % w/w Unit Formula Ingredient of Total (mg/tablet) EfavirenzPowder Blend 57.94 898.0 FTC/TDF Powder Blend 42.06 652.0 Total forTablet Cores 100.00 1550.0 Opadry II Pink 3.00 46.5 Purified Water,USP/EP^(a) Total for Film-Coated Tablets 1596.5 ^(a)Water removed duringfilm-coating process.The excipients were all compendial grade materials:

Efavirenz Wet Granulation

Efavirenz was wet granulated using a Niro-Fielder PMA-400 equipmenttrain. Efavirenz, microcrystalline cellulose and sodium lauryl sulfate(Table 1) were added to the PMA-400 and blended for 3 minutes.Croscarmellose sodium and hydroxyl propyl cellulose (Table 1) were addedto the pre-mix and blended for an additional 2 minutes. Purified waterwas added to form a suitable granulation followed by additional wetmassing after water addition. Table 4 lists the summary of granulationparameters used for two representative lots and sub parts. All sub partsused a water to efavirenz ratio of 1.30 except for AB509 Mix C whichused a 1.25 ratio of water to efavirenz.

TABLE 4 Efavirenz wet granulation process parameter summary AB507 AB509Mix Mix Mix Mix Mix Mix Process Parameter A B C A B C Granula- TotalWater 33.57 33.56 33.56 33.56 33.56 32.18 tion Added (kg) Ratio of 1.301.30 1.30 1.30 1.30 1.25 Water:EFV Total Addition 9:36 9:29 9:24 9:179:32 9:02 Time (Min:Sec) Final Impeller 10.4 9.8 8.5 11.3 11.3 9.9 Power(% Load) Wet Total Time 4:00 3:00 3:00 2:00 1:15 2:00 Massing (Min:Sec)Final Impeller 11.6 12.0 11.7 18.0 17.7 10.5 Power (% Load) Drying^(a)Inlet Temperature 70 70 (° C.) Time (Hr:Min) 1:45 1:51 Final Outlet 5050 Temp. (° C.) Final LOD 0.3 0.8 (%) ^(a)Mixes A, B, and C for each lotwere combined before drying.

In general, the wet granules were milled, then dried to an LOD less thanor equal to 1.5%. The dried granules were milled and blended withmagnesium stearate (Table 1).

The bulk density, particle size, and moisture content by LOD of theefavirenz granulations are listed in the first three lines of Table 5(the B lot numbers are efavirenz products, the C lot numbers areemtricitabine/tenofovir DF). Particle size was determined by sifting10-gram samples through 3-inch diameter screens using a sonic sifter(Model L3P, ATM Corporation, Milwaukee, Wis., USA). The following USStandard Mesh sizes (openings) were used: #20 (850 μm), #30 (600 μm),#40 (425 μm), #60 (250 μm), #80 (180 μm), and #250 (63 μm). Theagitation and pulse were set at 7 and the sifting time was 5 minutes.The amount of powder retained on the sieves and the fines collector wasdetermined by calculating the difference in weight before and aftersifting. The geometric mean particle size was calculated by logarithmicweighting of the sieved distribution.

Bulk density was determined by filling a 100-mL graduated cylinder withsample and calculating the difference in weight between the empty andfull graduated cylinder per unit volume.

Moisture content measurements by loss on drying (LOD) were performed byheating a 2.5 g sample at 85° C. for 15 minutes using a heatlamp/balance system (Model LP16/PM400, Mettler-Toledo, Columbus, Ohio,USA).

The granulations had similar bulk densities (0.54 to 0.56 g/mL) andsimilar geometric mean particle size distributions (215 to 268 μm). TheLOD values of the final blend were consistent from 0.98 to 1.80%. Theindividual sieve distributions for the efavirenz granulations are listedin Table 6.

TABLE 5 Summary of efavirenz powder blend and emtricitabine/tenofovir DFpowder blend physical properties Geometric Mean Diameter Gilead ParticleSize Bulk Density LOD Lot Number (μm) (g/mL) (%) AB507 247 0.56 1.80AB508 215 0.55 1.08 AB509 268 0.54 0.98 AC507 330 0.60 0.91 AC508 3440.60 1.02 AC509 343 0.59 0.99

TABLE 6 Particle size distribution for efavirenz and FTC/TDF powderblends % Weight Retained on Screen^(a) US Standard Screen Size (meshopening) Gilead 20 30 40 60 80 230 pan Lot (>850 (600 (425 (250 (180 (63(<63 Number μm) μm) μm) μm) μm) μm) μm) AB507 5.9 10.9 16.2 22.2 11.422.6 10.9 AB508 6.1 10.4 15.8 20.0 9.0 20.8 17.9 AB509 9.6 13.3 17.420.1 8.9 17.2 13.3 AC507 22.0 19.8 15.2 11.2 4.6 10.5 16.6 AC508 22.120.1 15.4 11.6 5.1 10.6 14.9 AC509 22.4 19.7 15.3 11.7 4.8 11.1 14.8

Emtricitabine/Tenofovir DF Dry Granulation

Emtricitabine, microcrystalline cellulose, tenofovir DF, andcroscarmellose (Table 2) were blended in a 650 L tote bin using a Gallayblender for 10 minutes. Magnesium stearate (Table 2) was added andblended for an additional 5 minutes. This pre-blend was then transferredto a 320-L Matcon bin fitted with a cone valve discharging station toassist with material transfer into the roller compactor hopper.

The pre-blend was roller compacted using a Gerteis Macro-Pactor model250/25/3 with 250 mm diameter by 50 mm wide smooth rolls. The roll gapthickness (2 mm), roll speed (10 rpm), compaction force (4 kN/cm),oscillating mill speed (75 rpm clockwise and counterclockwise), andoscillating mill screen opening (1.25 mm) were kept constant for allbatches. The oscillating mill angle of rotation was also the same forall lots at 150° clockwise and 140° counterclockwise.

There was no material handling issues among all three batches whilefeeding into the roller compactor. The entire roller compaction processproceeded without any apparent sign of heat accumulation on theequipment, product build-up, or melting. The granulations then wereblended with extragranular croscarmellose sodium (34% of total amount)and magnesium stearate (47% of total amount).

The particle size, bulk density, and LOD of the emtricitabine/tenofovirDF dry granulations were all similar for the three batches and arelisted in Table 5 (bottom 3 compartments). The geometric particle sizeswere very similar at from 330 to 344 μm. Bulk densities ranged from 0.59to 0.60 g/mL. The final blend LOD values were consistent from 0.91 to1.02%. The final powder blends have remarkably consistent physicalproperties.

The efavirenz and tenofovir DF granulations each have geometric meanparticle sizes that optionally range about from 100 to 600 μm, bulkdensities optionally ranging about from 0.1 to 1 g/mL and LOD valuesoptionally ranging about from 0.1 to 10% by weight.

Final Blends

The mass of efavirenz granulation and extragranular magnesium stearatewere adjusted appropriately based on the yield ofemtricitabine/tenofovir DF dry granulation. Efavirenz granulation andemtricitabine/tenofovir DF dry granulation were blended in a 3 cubicfoot V-blender for 10 minutes. Magnesium stearate was added and blendedan additional 5 minutes. Samples of the final powder blend were takenfrom 10 different locations after blending and analyzed for blenduniformity. The efavirenz and emtricitabine/tenofovir DF final powderblends showed acceptable blend uniformity and homogeneity for all threeactive ingredients indicating the robustness of the formulationregardless of the particle size or bulk density ofemtricitabine/tenofovir DF dry granulations and efavirenz granulations.The granulations and blending procedure would be satisfactory for theformulation on a larger scale.

Tablet Core Compression

Efavirenz/emtricitabine/tenofovir DF final powder blend was compressedinto tablet cores using a Stokes Genesis Model 757, 41 station bilayertablet press equipped plain-faced upper/embossed “123” lower,capsule-shaped (20.0 mm×10.4 ram) punches. The target mass of the tabletcores was 1550 mg. Samples of the core tablets were taken from a minimumof 20 equally spaced locations during the compression run and analyzedfor content uniformity. In general, all powder blends compressedsatisfactory on the rotary tablet press with respect to tablet hardness,friability, tablet thickness, tablet appearance, and tablet weightvariation. The compression operation was performed at a rate ofapproximately 500 tablets/minute (12 rpm press speed) or approximately0.8 kg/minute to deliver satisfactory tablet weight uniformity.

Tablet Film-Coating

Suitable film coatings are selected by routine screening of commerciallyavailable preparations. This activity is well within the skill of theordinary artisan. Each lot of tablet cores was divided into two coatingsub-lots that were film coated in a 48-inch Thomas Engineering COMPU-LABcoating pan using a dual-nozzle spraying system. All the tablet coreswere film-coated using a 15% w/w aqueous coating suspension Opadry IIPink, which was used within 24 hours of preparation. All tablet coreswere coated to a target weight gain of 3.0% using a target spray rate of180 g/min, which corresponds to a normalized spray rate of 1.5 to 2.3g/min/kg tablets.

HPLC Assay for Degradation Products

Efavirenz/emtricitabine/tenofovir DF tablets (EFV/FTC/TDF tablets) areassayed by HPLC for EFV, FTC, and TDF using external referencestandards. The degradation products of EFV, FTC, and TDF are determinedby area normalization with the application of relative response factors,as appropriate. The identity of EFV, FTC, and TDF are confirmed bycomparison of their retention times with those of the referencestandards.

Standard and Sample Solution Preparation Standard and Sample Solvent 25mM Phosphate Buffer, pH 3

Weigh and transfer 3.4 g of potassium phosphate monobasic, anhydrousinto a 1 L volumetric flask. Add about 800 mL of water and mix untildissolved. Adjust the pH to 3.0±0.1 with phosphoric acid, then dilute tovolume with water.

Sample Solvent (40:30:30 25 mM Phosphate Buffer, pH3:Acetonitrile:Methanol)

Combine 400 mL of 25 mM Phosphate Buffer, pH 3, 300 mL of acetonitrile,and 300 mL of methanol and mix. Allow to equilibrate to ambienttemperature.

50:50 Acetonitrile:Methanol

Combine 500 mL of acetonitrile and 500 mL of methanol and mix. Allow toequilibrate to ambient temperature.

Standard Solution

Accurately weigh approximately 60 mg of EFV reference standard, 20 mg ofFTC reference standard, and 30 mg of TDF reference standard and transferinto a 100 mL volumetric flask. Add approximately 80 mL of samplesolvent (40:30:30) to the flask and mix or sonicate until dissolved.Dilute to volume with sample solvent (40:30:30) and mix well. The finalconcentration of each component is approximately 0.6 mg/mL of EFV, 0.2mg/mL of FTC, and 0.3 mg/mL of TDF.

System Suitability Test Solutions Sensitivity Check Standard

Prepare a 10 μg/mL FTU stock solution by accurately weighing outapproximately 10 mg of the FTU authentic substance into a 100 mLvolumetric flask. Add sample solvent (40:30:30) to approximately 80% ofvolume and mix or sonicate until dissolved. Dilute to volume with samplesolvent (40:30:30) and mix well. Pipet 10 mL of this solution into a 100mL volumetric flask. Dilute to volume with sample solvent (40:30:30) andmix well.

Prepare the sensitivity check standard containing 0.2 mg/mL of FTC and0.2 μg/mL of FTU (0.10% relative to FTC). Accurately weigh out 20 mg FTCinto a 100 mL volumetric flask. Using a Class A pipet, transfer 2.0 mLof the FTU stock solution into the same flask. Add additional samplesolvent (40:30:30) to the flask and mix or sonicate until dissolved.Dilute to volume with sample solvent (40:30:30) and mix well.Alternately, 2.0 mL of the 10 μg/mL FTU stock solution may be added tothe standard solution prior to diluting to volume.

Sample Preparation for EFV/FTC/TDF Tablets

The strength and degradation product content of EFV/FTC/TDF tablets isdetermined by the analysis of a composite solution prepared from tentablets. The final concentration of each component in the samplesolution is approximately 0.6 mg/mL of EFV, 0.2 mg/mL of FTC, and 0.3mg/mL of TDF.

-   -   a) Place ten tablets into a 1 L volumetric flask and add 400 mL        25 mM phosphate buffer, pH 3 to the volumetric flask.    -   b) Mix by stirring vigorously for about 75 minutes.    -   c) Add 50:50 acetonitrile:methanol to the flask to approximately        2 cm below the volume mark.    -   d) Equilibrate the solution to ambient temperature by mixing for        an hour. Dilute to volume with 50:50 acetonitrile:methanol. Mix        well by inverting the flask or stirring with a magnetic stir        bar.    -   e) Using a 0.45 μm syringe filter with a syringe, filter        approximately 10 mL of step (d) for the next dilution. Discard        the first 2 mL of filtrate.    -   f) Using a Class A pipet, transfer 5.0 mL of the filtrate from        step (e) into a 50 mL volumetric flask and dilute to volume with        sample solvent (40:30:30). Mix well.

Chromatography

-   1. An HPLC equipped with a UV detector and an electronic data    acquisition system is used.-   2. An HPLC column, 4.6 mm i.d. by 250 mm long, packed with C12    reversed phase, 4 μm particle size, 80 Å pore size material is used.-   3. Mobile phase buffer: Prepare a 20 mM ammonium acetate buffer, pH    4.6; adjust pH with acetic acid as needed.-   4. Mobile phase gradient: Elute with Mobile Phase    Buffer:acetonitrile from 99:1 to 1:99 over 67 minutes.-   5. Peak detection: UV at 262 nm-   6. Injection volume: 10 μL.

Under the stated chromatographic conditions, the retention times of theFTC, TDF and EFV peaks are typically 11, 33, and 50 minutes,respectively.

Injection Sequence

Inject the sample solvent at least twice as a blank to ensure that thecolumn is equilibrated and to identify any potential artifact peaks.

Inject the sensitivity check standard or standard solution containingapproximately 0.10% FTU to measure the sensitivity of detection.

Inject five replicates of standard solution 1 (R1), followed by a singleinjection of standard solution 2 (R2). Calculate the theoretical platesand tailing factors from the standard solution injections.

For identity, strength, and degradation product determination, performduplicate injections of the sample solution.

All sample solutions must be bracketed by standard solution injections.Generally, not more than ten sample solution injections betweenbracketing standard injections is recommended.

System Suitability Theoretical Plates and Tailing Factor

Calculate the number of theoretical plates (N) and the tailing factors(T) for the EFV, FTC, and TDF peaks from the Standard Solutionchromatogram. The formulas for N and T determination are defined in thecurrent United States Pharmacopeia. The values of these parameters mustconform to the criteria: N≦40,000 and 0.8≦T≧2.0.

Sensitivity Check

The sensitivity check will utilize the FTU peak in the sensitivity checkstandard present at approximately 0.10%. Calculate the area percent ofthe FTU peak with the appropriate RRF (listed in Table 2) applied forthe sensitivity check standard using the calculation for percentindividual degradation product. Compare this result to the theoreticalpercent of FTU for the sensitivity check standard as follows:

${Sensitivity} = \frac{{FTU}_{Deteremined}}{{FTU}_{Theoretical}}$

-   Where: FTU_(Determined)=area percent of FTU determined for the    sensitivity check standard or standard solution    -   FTU_(Theoretical)=theoretical area percent of FTU for the        sensitivity. check standard or standard solution

The sensitivity must be between 0.704.30.

Evaluation and Calculations Identification of Degradation Products

Employ the appropriate detection parameters (such as peak threshold,minimum peak area, etc.) to allow detection of peaks present at 0.05% orless. Identify the impurities and degradation products of EFV, FTC, andTDF present in the chromatograms of the sample solution injections bynoting the relative retention times (RRT) of the observed secondarypeaks, discounting any peaks not related to the sample. Only degradationproducts are quantified. Calculate the average of the results from allsample solution injections to the nearest 0.01%. In cases where thedegradation product was not detected or was below the threshold ofintegration in one injection and/or sample, use only the quantifiedresults in the calculation (i.e., do not treat as a zero value).

${RRT} = \frac{{retention}\mspace{14mu} {time}\mspace{14mu} {of}\mspace{14mu} {the}\mspace{14mu} {secondary}\mspace{14mu} {peak}}{{retention}\mspace{14mu} {time}\mspace{14mu} {of}\mspace{14mu} {the}\mspace{14mu} {tenofovir}\mspace{14mu} {disoproxil}{\mspace{11mu} \;}{peak}}$

The RRTs and the relative response factor (RRF) values of the potentialimpurities and degradation products for EFV are shown in Table 1, andthe degradation products are shown in bold-face. The impurities anddegradation products for FTC are shown in Table 2, and the degradationproducts are in bold-face. The impurities and degradation products forTDF are shown in Table 3, and the degradation products are in bold face.

As the RRT may vary, the identity of impurities and degradation productsmay be confirmed by comparison to authentic substances (or to impurityand degradation product peaks in the reference standard), if required.

Degradation Product Content Determination

Quantification of FTC Degradation Products

-   -   Determine the level of each degradation product of FTC observed        in the chromatograms of the sample solution injections using the        following formula:

${{Degradation}\mspace{14mu} {Product}\mspace{14mu} (\%)} = {\frac{I}{TPA} \times {RRF} \times 100}$

-   -   Where: I=Area of the degradation product peak        -   TPA=Total peak area (area of FTC and all related degradation            products, excluding impurities and artifacts), corrected by            RRF    -   RRF=Relative response factor with respect to FTC

8.4.3 Quantification of TDF Degradation Products

-   -   Determine the level of each degradation product of TDF observed        in the chromatograms of the sample solution injections using the        following formula:

${{Degradation}\mspace{14mu} {Product}\mspace{14mu} (\%)} = {\frac{I}{TPA} \times {RRF} \times 100}$

-   -   Where: I=Area of the degradation product peak or unassigned peak        -   TPA=Total peak area (area of the TDF main peak, all related            degradation products, and all unassigned peaks, excluding            impurities and artifacts), corrected by RRF        -   RRF=Relative response factor with respect to TDF

Results and Reporting Degradation Product Content

Report individually the average of the results for each degradationproduct observed to the nearest 0.01%. Report the total degradationproduct content of EFV, FTC, and TDF respectively to the nearest 0.1%,as the sum of the average levels of all degradation product peaksobserved. For degradation products found at levels less than 0.05%,report their levels as trace and do not include their levels in thecalculation of total degradation product content.

REFERENCES

-   United States Pharmacopeia <621>-   Pharmacopeial Forum 26(4) 2000

TABLE 1 EFV related impurities and degradation products EFV RelatedApproximate Compound RRT^(a) RRF^(b) SD-573 ^(c) 1.46 0.5 SR-695^(d)1.50 EFV 1.50 SP-234 1.57 SW-965 1.60 SE-563 1.73 SM-097 ^(c) 1.83 0.5^(a)Approximate RRTs, and the values are relative to the TDF peak^(b)RRFs for EFV related degradation products are relative to EFV^(c)EFV related degradation products ^(d)SR-695 elutes before EFV(approximately 0.1 min separation) Degradation products are marked inbold face

TABLE 2 FTC related degradation product FTC Related Approximate CompoundRRT^(a) RRF^(b) FTC 0.33 FTU ^(c) 0.38 0.7 ^(a)Approximate RRTs, and thevalues are relative to the TDF peak ^(b)RRFs for FTC related degradationproducts are relative to FTC ^(c)FTC related degradation products

TABLE 3 Tenofovir DF related degradation products TDF RelatedApproximate Compound RRT^(a) RRF^(b) mono-POC PMPA ^(c) 0.47 0.6 MixedDimer ^(c) 0.98 1.0 TDF 1.00 Dimer ^(c) 1.34 0.9 ^(a)Approximate RRTs,and the values are relative to the TDF peak ^(b)RRFs for TDF relateddegradation products are relative to TDF ^(c)TDF related degradationproducts

What is claimed:
 1. A composition comprising tenofovir DF and asurfactant whereby the surfactant is in a stabilizing configuration withthe tenofovir DF.
 2. The composition of claim 1 additionally includingefavirenz and emtricitabine.
 3. The composition of claim 2 wherein thetenofovir DF and emtricitabine are in a first component and theefavirenz and the surfactant are in a second component.
 4. Thecomposition of claim 3 wherein the first component and the secondcomponent are physically discrete but are in contact with one another.5. The composition of claim 4 wherein the components are layers.
 6. Thecomposition of claim 5 which is suitable for oral administration.
 7. Thecomposition of claim 5 which is a bilayer tablet weighing less thanabout 2.5 grams.
 8. The composition of claim 3 wherein component 2 isproduced by high shear wet granulation.
 9. The composition of claim 1wherein the detergent is sodium lauryl sulfate.
 10. The composition ofclaim 3 wherein component 1 is produced by dry granulation.
 11. Thecomposition of claim 2 wherein the total amount of efavirenz,emtricitabine and tenofovir DF is greater than about 60% by weight ofthe composition.
 12. The composition of claim 2 which further comprisesmagnesium stearate, croscarmellose sodium, microcrystalline celluloseand hydroxypropyl cellulose.
 13. The composition of claim 12 wherein theapproximate percentages by weight of efavirenz, tenofovir DF,emtricitabine, magnesium stearate, croscarmellose sodium,microcrystalline cellulose, sodium lauryl sulfate, and hydroxypropylcellulose are, respectively, about 39, about 19, about 13, about 2,about 7, about 17, about 1 and about
 2. 14. The composition of claim 2wherein efavirenz, emtricitabine and tenofovir DF are provided to apatient upon oral administration at substantially the same AUC and Cmaxas the FDA approved products Truvada and Sustiva.
 15. The composition ofclaim 7 which weighs about from 1200 mg to 2300 mg (including any filmcoating that is optionally present).
 16. The composition of claim 7wherein the layers are oriented horizontally along an axis of thetablet.
 17. A container comprising the composition of claim 1 and adesiccant.
 18. A method comprising preparing component 1 comprisingtenofovir DF, preparing component 2 comprising efavirenz and asurfactant, and placing both components into stabilizing configurationwith one another.
 19. The method of claim 18 wherein component 1 alsocomprises emtricitabine.
 20. The method of claim 19 wherein component 1is made by dry granulation and component 2 is made by wet granulation.21. The method of claim 20 wherein dry granulated tenofovir DF andemtricitabine are combined with magnesium stearate, wet granulatedefavirenz is combined with magnesium stearate and the two magnesiumstearate compositions compressed into a bilayer tablet.
 22. A methodcomprising orally administering the dosage form of claim 1 to a patientin need of antiviral therapy.
 23. The method of claim 22 wherein thedosage form is administered only once daily.
 24. The method of claim 23wherein the antiviral therapy is anti-HIV therapy.
 25. A productcomprising emtricitabine, tenofovir DF and efavirenz, a surfactant, anda means for preventing destabilizing contact between the surfactant andtenofovir DF.
 26. A composition comprising emtricitabine, tenofovir DFand efavirenz which is free of pharmaceutically unacceptableconcentrations of FTU, mono-POC PMPA, dimer and mixed dimer.
 27. Thecomposition of claim 26 wherein the concentrations of FTU, mono-POCPMPA, dimer and mixed dimer are, respectively by weight %, 3.9, 9, 1.6,and 1.8.
 28. The composition of claim 27 wherein the concentrations aredetermined after storage of the composition at 25° C./60% RH for 24months.
 29. A unitary dosage form comprising component 1 comprisingtenofovir DF, and emtricitabine and component 2 comprising efavirenz anda surfactant, component 1 being spatially disposed in stabilizingconfiguration with component
 2. 30. The dosage form of claim 29 which issuitable for oral administration.